Epidemic-prone Disease Case Surveillance (EDCS)
Data Management Training among Epidemiology Surveillance
Unit/ Disease Reporting Unit (ESU/DRU) Staff
Overview of Food and
Water-Borne Diseases
Surveillance
Daryl Jay L. Lopez, RN
Food and Water-borne
Diseases
Overview of Food and Water-Borne Diseases
Learning Objectives
• Enumerate notifiable diseases under the FWBD cluster
• Identify cases using case definitions
• Detect, register and report FWBD cases using EDCS core
processes
Food and Water-borne
Diseases
Food and
Vaccine Preventable
Water-borne Zoonotic Diseases Other Diseases
Diseases (VPD)
Diseases (FWBD) Hand, Foot and
Mouth Disease
Acute Flaccid Paralysis Acute Bloody Diarrhea Chikungunya
Acute Meningitis
Diphtheria Encephalitis Sydrome
Acute Viral Hepatitis
Measles Dengue
Influenza Like Illness
Neonatal Tetanus Cholera
Non-neonatal tetanus Leptospirosis
Rotavirus Meningococcemia
Pertussis
Typhoid Fever Rabies Severe Acute
Rubella Respiratory Infection
Food and Water-borne
Diseases
Food and Water-Borne Importance of FWBD Surveillance
Disease Cluster (FWBD) ● To detect and provide data to control
outbreaks
Acute Bloody Diarrhea ● To provide valuable insights into the agents
and foods that cause illness and the
Acute Viral Hepatitis-A settings where contamination occurs
● To guide public health decision-making on
Cholera the most appropriate intervention and
control strategy by using timely and
Rotavirus accurate surveillance data.
Typhoid Fever
Food and Water-borne
Diseases
ACUTE BLOODY DIARRHEA
Food and Water-borne
Diseases
Acute Bloody Diarrhea (ABD)
▪ Acute bloody diarrhea is also called dysentery.
▪ Bloodydiarrhea usuallya sign of invasive
enteric infection that carries a substantial risk of
serious morbidity and death, especially in
children in developing countries.
▪ Overcrowded areas with unsafe drinking water
and poor sanitation are the most common risk
factors for ABD.
Food and Water-borne
Diseases
Acute Bloody Diarrhea (ABD)
▪ The disease is characterized by acute fever
and bloody diarrhea, and can also present
with systemic symptoms and signs as
well as dehydration especially in young
children.
▪ Shigella dysenteriae is most frequently
isolated from the stools of affected children and
is transmitted from person-to-person through
the fecal-oral route.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
1. ACUTE BLOODY DIARRHEA (ABD)
Case Classification:
Suspect: A person with diarrhea with visible blood in the stool.
Confirmed Case: A suspect with stool positive for bacterial and
parasitic pathogens(i.e Shigella dysenteriae type 1, Entamoeba
histolytica or Escherichia coli) thru bacterial culture or any molecular
diagnostic test.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
1. ACUTE BLOODY DIARRHEA (ABD)
Case Classification:
Laboratory test:
Stool/rectal swab: for Bacteriology culture; Clinical microscopy
(Salmonella ssp., Shigella dysenteriae , Campylobacter jejuni.
Aeromonas, Entamoeba histolytica, E. coli)
Cases to look out for:
Increasing number of bloody diarrhea from one barangay/municipality
over a short period of time.
Food and Water-borne
Diseases
Food and Water-borne
Diseases
Food and Water-borne
Diseases
CHOLERA
Food and Water-borne
Diseases
CHOLERA
Cholera is an acute bacterial infection caused by the enterotoxin of the
bacterium Vibrio cholerae 01 or 0139 . It is characterized by sudden onset of
profuse, painless, rice watery diarrhea, nausea and vomiting.
∙ It is transmitted through ingestion of food or water contaminated with vomitus or
feces of infected person.
∙ Some of the most common risk factors include: eating or drinking of
contaminated food such as uncooked seafood or shellfish from unsafe waters,
lack of access to safe drinking water, eating in large gatherings of people such
as weddings or funerals, and close contact with persons who died of cholera.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
2. CHOLERA
Case Classification
• Suspected Case:
A suspected case is any patient aged ≥ 2 years who has acute rice
watery diarrhoea and severe dehydration or died from acute watery
diarrhoea.
(Acute watery diarrhoea is characterized by three or more loose or
watery, non-bloody stools within a 24-hour period.)
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
2. CHOLERA
Case Classification
● Probable Case:
A suspected case that is cholera RDT positive.
● Confirmed Case:
A suspected case that is laboratory-confirmed. (Isolation of Vibrio
cholerae 01 or 0139 from stools in any patient with diarrhea by culture or
Any molecular diagnostic test)
Food and Water-borne
Diseases
Food and Water-borne
Diseases
Food and Water-borne
Diseases
ACUTE VIRAL HEPATITIS
Food and Water-borne
Diseases
ACUTE VIRAL HEPATITIS
Viral Hepatitis is an infection that causes liver
inflammation and damage. Inflammation is
swelling that occurs when tissues of the body
become injured or infected.
∙ Heavy alcohol use, toxins, some medications, and
certain medical conditions can cause hepatitis.
∙ Common in many countries, especially those
without modern sanitation.
Food and Water-borne
Diseases
ACUTE VIRAL HEPATITIS
∙ Hepatitis A is a liver disease caused by the
hepatitis A virus (HAV).
∙ The hepatitis A virus is transmitted primarily
through oral fecal route.
∙ Symptoms of hepatitis A range from mild to
severe, and can include fever, malaise, loss
of appetite, diarrhea, nausea, abdominal
discomfort, dark-coloured urine and jaundice.
∙ The incubation period of hepatitis A is usually
14–28 days.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
3. ACUTE VIRAL HEPATITIS A
Case Classification
Suspected case – a person with acute illness characterized by acute
jaundice, dark urine, loss of
appetite, body weakness, extreme fatigue and right upper quadrant
tenderness.
Confirmed case – a suspected case that is laboratory confirmed for IgM
or anti-HAV.
Laboratory test -serum: for serology
Food and Water-borne
Diseases
Food and Water-borne
Diseases
Food and Water-borne
Diseases
Rotavirus
Food and Water-borne
Diseases
ROTAVIRUS
• According to WHO Rotavirus is the
leading cause of severe diarrheal disease
and dehydration in infants and young
children throughout the world.
• Rotavirus is common, accounting for
35–60% of acute severe diarrhoea in
children < 5 years of age in countries
without rotavirus vaccine, with the
highest attributable percentage in
infants. Photo source: WHO website, Regional of Africa
Food and Water-borne
Diseases
ROTAVIRUS
• Rotavirus is highly communicable; it is
shed in the stool at high concentration,
and transmission is through faecal-oral
route, either person-to-person or through
fomites in the environment.
• The incubation period is one to three
days.
Photo source: WHO website, Regional of Africa
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
4. ROTAVIRUS
Case Classification
• Suspected Case:
• Any child who is <5 years of age and is currently
undergoing treatment for acute diarrhea*
• Confirmed Case:
• A suspected case that has been laboratory-confirmed as Rotavirus.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
4. ROTAVIRUS
Case Classification
Notes:
• A child <5 years of age includes children aged 0 to 4 years, 11
months and 29 days;
• ‘Undergoestreatment’ means that the child has
received intravenous (IV) rehydration therapy while
undergoing observation in the Emergency Room (ER) or was
admitted in the hospital ward for acute diarrhea;
• ‘Acute diarrhea’ is defined as the passage of three or more loose or
watery stools within a 24-hour period for ≤14 days;
Food and Water-borne
Diseases
Food and Water-borne
Diseases
TYPHOID FEVER
Food and Water-borne
Diseases
TYPHOID FEVER
• Typhoid fever and paratyphoid fever are life-threatening
illnesses caused by Salmonella serotype Typhi and
Salmonella serotype Paratyphi, respectively.
• Typhoid fever and paratyphoid fever have similar
symptoms. People usually have a sustained fever
(one that doesn’t come and go) that can be as high as
103–104°F (39–40°C)
Photo source: CDC website
• Other symptomsof typhoid fever include weakness,
stomach pain, headache, diarrhea or constipation,
cough, loss of appetite.
• The disease is transmitted via oral-fecal route.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
5. TYPHOID
Case Classification
• Suspected Case: A person with an illness characterized by
insidious onset of sustained fever, headache, malaise, anorexia, relative
bradycardia, constipation or diarrhea, and non-productive cough.
• Probable Case: A suspected case that is epidemiologically linked to a
confirmed case in an outbreak.
• Confirmed Case: A suspected or probable case that is laboratory
confirmed.
Food and Water-borne
Diseases
Case Definitions For The Food And Water-borne Diseases (FWBD)
Surveillance Cluster
5. TYPHOID
Case Classification
• Laboratory test:
- Blood – 1st week Urine / stool – 2nd-3rd week : Bacteriology culture
(Salmonella typhi, salmonella paratyphi)
Note: Serological tests for typhoid fever (e.g. Widal test and Typhidot) may
be used only for presumptive diagnosis. It should not be used as a
confirmatory diagnostic tool for typhoid. Hence, cases diagnosed using
such method will remain classified as suspect cases.
Food and Water-borne
Diseases
Food and Water-borne
Diseases
Vaccine Preventable Diseases
